Modernisation of clinical scientist training in Medical Physics and Clinical Engineering

1. Modernisation of clinical scientist training in Medical Physics and Clinical Engineering Amicus/HPA Annual Delegate and Professional Conference 20th October 2006

2. Drivers for change • Modernisation of pre-registration education and training • Independently quality assured • Too long and too expensive • Healthcare Science career pathway • More consultants – more like medical model • More associate practitioners • Foster review of non-medical regulation – agreement to record post-registration qualifications in the register

3. Pre registration Education and Training Modernisation • Approved by Ministers, UK wide acceptance • Part of HCS work programme within Skills for Health • Aim to modernise pre-registration education and training both regulated groups and all aspirant groups • Funding and commissioning arrangements

4. General principles • “Fitness for practice” programmes • Defined scope of practicelinked to service needs appropriate to level of underpinning knowledge • Professional (workplace) practice embedded within programmes/awards, informed by HCS NOS and linked to robust assessment of competence • Independently assessed and quality assured • Clear APEL arrangements to facilitate fast tracking • Opportunities for common approaches to delivery ( generic/core)

5. Considerations • Streamlining of modalities/sub modalities • Nationally defined scope of practice • Supports different routes of entry • Education and Training programmes funded and commissioned – need to submit to spending review in early 2007 • Salary versus bursary • Linked to Higher Specialist Trainingwith consultant as career grade

6. Future model of regulation Scope of Practice Standardised Education and Training Protected Title

7. Clinical Science Scope of Practice - i • Plan a range of investigations / procedures / processes to support and improve patient care in the context of patient, samples and/or technology. • Perform a range of specialist scientific / clinical investigations / procedures / processes to support patient care in the context of the patient, samples and/or technology • Plan and prospectively review / instigate patient treatment or management programmes for groups or individuals and/or technologies.

8. Clinical Science Scope of Practice - ii 4. Report and interpret results of investigations, procedures or processes for patients / samples / measurements / technology 5. Monitor and report on progress of the patient conditions / technology and the need for further intervention. 6. Apply and maintain and be capable of setting quality standards, control and assurance techniques, including restorative action, assure high quality interventions across all clinical scientific and technological activity.

9. Clinical Science Scope of Practice - iii 7. Provide clinical and/or scientific advice and information to healthcare and other professionals, patients and their carers to support effective assessment, diagnosis, management and treatment of patients and/or patient services. 8. Communicate clinical and/or scientific knowledge to a range of audiences, including professionals and patients 9. Plan, organise and prioritise own work activities, practices and tasks

10. Clinical Science Scope of Practice - iv 10. Undertake peer reviewed research and disseminate results. 11. Using Knowledge Management techniques including critical appraisal undertake audits and service development to improve quality of service provided.

11. Scope of Practice • Defined scope of practice • Clinical Scientist is too broad • IPEM view to keep the scope of practice and protected title as broad as possible (Clinical Engineer, Medical Physicist) • Defines the learning outcomes for the education and training • BUT remember we currently register people within modality and not within broad scope of practice • AND we have the tension between the narrowness of the scope of practice and the viability of education & training

12. Radiotherapy Physics Nuclear Medicine Physics Diagnostic Radiology Radiation Safety MR Ultrasound Non-ionising  85% Medical Physics Biomechanical Evaluation and function Medical Instrumentation and Computer Science Assistive technology Clinical Measurement Medical Engineering Design Medical Equipment management  Clinical Engineering 15% Proportion of trainees Higher specialist areas Broad scopes of practice

13. Generic scope of practice Required competence 1.Plan a range of investigations/ procedures/processes to support patient care in the context of patient, samples and/or technology. CC 1.2 Identify problems, formulate hypotheses and develop an experimental plan to resolve a problem; Develop methods to evaluate new and existing imaging technologies CC 1.3 select and use appropriate measuring equipment; CC2.1 Apply basic engineering principles to health care ED1.2 Prepare and present an appropriate outline project plan

14. Professional doctorate model • 3 years is a given • 2 terms academic, 3 terms research project, 4 terms professional practice • Elective in second summer • Relevant PhD – no need to do research element – registration in 2 years • May be able to extend programmes to real PhD • Must link to HST • Proposal – NOT accepted by DH yet. • Start September 2008 at the earliest • Good feedback from HEIs • More than part I but less than part II

15. Common core training • One third of IPEM MSc syllabus core content • Two thirds specialist modules • Do not want to change that balance • MSc syllabus maps reasonably well onto SFH common core training – some gaps on both sides • Subject of further debate

16. Higher specialist training(HST) • Those seeking to act as consultants • MRCPath for Clinical Biochemists • There need to be a similar model for Clinical Engineers and Medical Physicists in the NHS • Link to appropriate Royal College? • Mark on the register • This must be in place if we are to accept the changes to pre-registration training

17. Risks • Current MSc programmes rely on overseas students and self-funders to remain viable – need to retain flexibility for Universities to keep course viable • No HST scheme in place for medical physics & clinical engineering. IPEM need to develop a professional body exam equivalent to MRCPath. Possible link to a Royal College • Too much emphasis on common module approach at the expense of specialist training • Management of clinical practice placements – ownership of trainees • Bursaries – need to attract high calibre applicants • Maintain flexible routes of entry

18. Summary • Change is a given • Aim for career grade to be consultant and medical model of training • Generic scope of practice acceptable • 2 scopes of practice – Medical Physics and Clinical Engineering • 3 year programme in the university sector a given • IPEM supports the professional doctorate model • Recognise that this is a different animal • Link to HST a must • Need to develop HST • Avoid loss of teaching time on specialist training